O.6 Laboratory biomarkers of severe COVID-19 in pregnancy

Abstract

Introduction: Elevated D-dimer is associated with worse outcomes from COVID-19 in non-pregnant adults.[1]Kermali M, Khalsa RK, Pillai K, et al. The role of biomarkers in diagnosis of COVID-19- A systematic review. Life Sci 2020 Aug 1;254:117788Google Scholar We analysed laboratory parameters of pregnant women with PCR swab positive COVID-19 to identify biomarkers associated with severe infection. Methods:After ethical approval, anonymised observational data were collected on pregnant women admitted with PCR swab positive COVID-19. Infection was classified as mild (asymptomatic screen positive/mild symptomatic) or severe (requiring organ support). Information collected included symptoms, demographic and pregnancy data, blood results and outcome data. Sequential women having planned caesarean section with negative COVID-19 PCR were controls. Results: 34 women with PCR positive COVID-19 were recruited between 10 June–31 December 2020; 15 were asymptomatic. Median day of presentation from symptom onset was 3 (IQR, range) (3, 0–12). Control, mild and severe groups had median ages of 32, 30.5 and 31; gestation of 39, 38+6 and 31+5 and BMI of 27, 28, 28, respectively. The proportion of smokers was 12%, 11% and 17%; and diabetics 13%, 14% and 17%. BAME was 23%, 40% and 67%. In the severe group, 6 required supplemental oxygen, 1 progressed to invasive ventilation. None required renal support. Discussion: Lymphocytopenia and higher CRP at admission were associated with increased disease severity similar to non- pregnant adults. BAME women were over represented in the severe COVID-19 group. D-dimers were indistinguishable between mild and severe COVID-19 groups in contrast to non- pregnant adults so cannot be used as a predictive biomarker.